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1659349900
SUSAN L LAVICTOIRE
OKLAHOMA CITY, OK
NPI
1659349900
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: OK 1172)
Enumeration Date
2006-03-11
Last Update Date
2007-07-08
Business Address
-- SUSAN L LAVICTOIRE PA
940 NE 13TH ST 3B3311
OKLAHOMA CITY, OK 73104-5008
Phone number: 405-271-5789
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Mailing Address
-- SUSAN L LAVICTOIRE PA
1122 NE 13TH ST ORI236
OKLAHOMA CITY, OK 73117-1039
Phone number: 405-271-1515
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